Wednesday, February 3, 2016

Book 6- "the Checklist Manifesto" by Atul Gawande

This book fulfills the "A book recommended to you by your spouse" category on the Modern Mrs. Darcy challenge. Brandon had this book loaned to him by his supervisor during his surgery rotation, and he told me I had to read this as well.
Now, I LOVE making checklists. While teaching Special Ed, I had a checklist of how to write each student's IEP, what goes into making a goal with the benchmarks that they need to meet, what I needed to do all day with each student, how to run each meeting. I even wrote out a checklist of what needed to be done every day with one student, divided into 15 minute increments. It is such a great way to feel organized. I have planners and journals to keep me organized, even now. I always have to have lists at the grocery store, because if I don't then we end up wandering the aisles and end up with 2 boxes of cookies and 8 different kinds of juice. Not very productive.
This book is about the benefits of making checklists in the medical field, and covers examples of checklists and dispersing the responsibility in other fields. 
One example was while making a skyscraper. They need to have a complicated system of communication between each specialty in order to make sure that the building works the way it is supposed to. They also need to have a checklist for each complication that can happen, to make sure that each worker knows what their role is. This was so interesting to me because we live right now in the land of skyscrapers. From our balcony, I can count at least 7 skyscraper apartment buildings. So to learn a little bit of what goes into them is amazing.
Another great example was WalMart during Hurricane Katrina. The federal government didn't come in time to help the people who were stranded at the SuperDome, or thousands of people who were stranded on an I-10 overpass (terrifying!). When the executives at WalMart heard from their employees about the awful state that New Orleans was in, they jumped in and helped out themselves. They had employees passing out formula and diapers to people who needed them, or axes and shovels for people who had to help dig someone else out. Because the executives were willing to let go of total control (which was the issue FEMA had), they were able to help people that much quicker.
Another example is in the operating room itself. The checklist allows all roles to feel included and involved, and to allow everyone to communicate their issues. 64% of surgeons surveyed said that they thought their communication was just fine, but only 23% of anesthesiologists felt that the communication went well.
Finally, the example that I really was interested in regarded airplane pilots. They have a list of 200+ checklists, some mundane and some for the unheard of. For example, when the cargo door gets loose. That creates a serious drop in pressure in the cabin. In an incident in 1989, a hole was actually blasted in the side of business class, and sucked 9 people out of the airplane on a flight from Honolulu to New Zealand. That is TERRIFYING. So, because of that they now have more notifications on the dashboard that the crew can identify, and more lists to help the crew stay calm.
Overall, it has been a difficult transition to getting these lists into the operating room, but it has cut down on errors and helped reduce turnover of staff. I am excited to be starting my online master's degree in March (!!!) in Special Education, and you'd better believe that I will be making checklists along the way to stay on top of my studies!

No comments:

Post a Comment